Barriers to Pursuing Dermatology in Canada: A Critical Qualitative Analysis of Medical Students from Underrepresented Backgrounds

BACKGROUND: Dermatology is 1 of the least diverse medical specialties in North America. Despite this, the barriers that Underrepresented in Medicine (URiM) students face in pursuing dermatology are poorly understood. This study aims to explore the challenges URiMs encounter in pursuing dermatology in Canada, with the goal of informing initiatives to enhance diversity and inclusivity within the field. METHODS: Using critical qualitative inquiry and purposive sampling to ensure gender, race/ethnicity, geographical, and trainee year heterogeneity, we recruited self-identifying URiMs across Canadian medical schools. Online in-depth semi-structured interviews were conducted and transcribed verbatim. Transcripts were analyzed through an inductive reflexive narrative thematic process, and key themes and subthemes were identified. RESULTS: Twenty-four URiMs were included in this study. The interviews revealed 3 major themes that characterized their experiences: journey to medicine and dermatology, sense of belonging in the field, and access to dermatology. URiMs identified limited mentorship, insufficient exposure to the field, financial constraints, undervaluation of advocacy efforts, feelings of isolation, and microaggressions as key barriers to pursuing dermatology. They recommended strategies to address these challenges, including mentorship programs, more holistic residency program selection approaches, and leveraging social media to increase exposure and highlight diversity in dermatology programs. CONCLUSIONS: This study highlights key barriers URiMs face in pursuing dermatology and provides a foundation for future research and policy changes to increase diversity in the specialty. We strongly encourage dermatology residency programs to implement these recommendations, as doing so will foster greater inclusivity and ultimately improve care for diverse patient populations.